During the past year we have continued our work applying rapid MRI to guide simple and complex mechanical and biological interventions. We have expanded a family of procedures in animal models to enter and exit the heart gracefully directly through the chest wall without surgical exposure. We intend these to allow large cardiovascular implants such as mitral valve replacements. We intend these also to allow direct repair of congenital heart defects on small children who otherwise might require open surgical access. NHLBI Cardiothoracic Surgery Research Branch investigators have used our interventional MRI system and environment to further test the feasibility and utility of real-time MRI guidance for surgical transapical implantation of a custom aortic stent valve bioprosthesis in swine. We have performed, for the first time, routine MRI-guided right heart catheterization in a series of patients. Overall we have successfully developed novel applications of real-time MRI for cardiovascular treatments, and we continue to work to clinical applications of these exciting new developments.